scholarly journals NGOs, austerity, and universal health coverage in Mozambique

2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
James Pfeiffer ◽  
Rachel R. Chapman
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Universal Health Coverage ◽  
Public Health System ◽  
Health Coverage ◽  
Donor Funding ◽  
The Public ◽  
Public Sector Health ◽  
Universal Health

AbstractIn many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country’s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow “off-budget” to NGO “implementing partners,” with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.

scholarly journals Progress of health care in rural India: a critical review of National Rural Health Mission

2017 ◽  
Vol 5 (1) ◽  
pp. 4 ◽  
Author(s):  
S. Gopalakrishnan ◽  
A. Immanuel
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Public Health System ◽  
National Rural Health Mission ◽  
Rural India ◽  
Health Coverage ◽  
The Public ◽  
Public Health Infrastructure

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.

Health strike is unlikely to shape Kenya national vote

2017 ◽  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Content Type ◽  
The Public ◽  
General Elections ◽  
Slow Progress ◽  
National Settlement

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

scholarly journals Access to medication in the Public Health System and equity: populational health surveys in São Paulo, Brazil

2016 ◽  
Vol 19 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Camila Nascimento Monteiro ◽  
Reinaldo José Gianini ◽  
Marilisa Berti de Azevedo Barros ◽  
Chester Luiz Galvão Cesar ◽  
Moisés Goldbaum
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Socioeconomic Position ◽  
Concentration Index ◽  
Public Health System ◽  
Sao Paulo ◽  
São Paulo ◽  
Cross Sectional ◽  
The Public

ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.

scholarly journals Resilient Health System for management of climatic and biological disasters in India

2020 ◽  
Author(s):  
Shipra Agarwal
Keyword(s):  
Public Health ◽  
Health System ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Research Article ◽  
System Resilience ◽  
Universal Health

This research article will help us to understand the health system resilience during public health disastersconcerning recent pandemic Covid-19 and goal for universal health coverage 2030.

scholarly journals The impact of the fragile health system on the implementation of health policies in Yemen

2020 ◽  
Author(s):  
Taha Hussein ◽  
Fekri Dureab ◽  
Raof Al-Waziza ◽  
Hanan Noman ◽  
Lisa Hennig ◽  
...  
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Universal Health Coverage ◽  
Peace Building ◽  
Health Policies ◽  
Health Coverage ◽  
Health Security ◽  
The Public ◽  
The Impact ◽  
Universal Health

The on-going humanitarian crisis in Yemen is one of the worst in the world, with more than14 million people in acute need. The conflict in Yemen deteriorated the already fragile health system and lead to the collapse of more than half of the health facilities. Health system fragmentation is also a problem in Yemen, which is complicated by the existence of two health ministries with different strategies. The aim of this study is to evaluate the effect of health system fragmentation on the implementation of health policies in Yemen across the global agendas of Universal Health Coverage (UHC), Health Security (GHS) and Health Promotion (HP) in the context of WHO priorities achieving universal health coverage, addressing health emergencies and promoting healthier populations. Methods The study is qualitative research using key informant in-depth interviews and documents analysis. Results There are many health stakeholders in Yemen, including the public, private, and NGO sectors - each with different priorities and interests, which did not always align with national policies and strategies. The WHO and Ministry of Public Health and Population (MoPHP) are the main supporters to implement all policies related to the UHC, GHS and HP agendas. Interestingly, initiatives initially pursuing a health security approach to control the cholera epidemic realigned with the UHC concept and moved from an initial focus on health security, to propose a minimum health service package, a classical UHC intervention. Overall, Universal Health Coverage is the most adapted agenda, health security agendas were highly disrupted due to conflicts and health staffs were caught unprepared for emerging outbreaks. The health promotion agenda was largely ignored. Conclusion Restoring peace, building on synergies between the three health agendas through joint planning between the MoPHP and other health actors are highly recommended.

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